Non-combat injuries, illnesses are No. 1 hazard in Iraq

CAMP VICTORY, Iraq — High blood pressure, bad backs, bum knees and other mundane health problems put three and a half times more troops on planes to hospitals in Germany or the United States than do snipers and roadside bombs, say front-line experts in Iraq.

"There's nothing about being deployed or being in an austere environment that protects you from the normal maladies that people encounter in the United States," said Lt. Col. Ron Ross, a preventive medicine officer with the U.S. Army's 62nd Medical Brigade in Iraq.

From the invasion in March 2003 through Oct. 1, 2007, more than 36,000 U.S. troops were evacuated from Iraq. More than 77 percent of those were for illnesses or non-combat injuries, according to data from the Department of Defense, Deployment Health Support Directorate.

Most eventually return, said Ross, but the illnesses and accidents still cut into troop strength.

This is nothing new. Traditionally, such problems — which the military lumps together as Disease and Non-Battlefield Injuries (DNBI) — take more troops from the battlefield than combat injuries do, though modern medical care and public health techniques have cut the rate suffered by U.S. troops in Iraq and Afghanistan to 10 percent of what it was in World War II and Korea.

An example of that success is the U.S. fight against leishmaniasis, a parasitic disease spread by sandflies that causes festering wounds and can attack the organs.

When the British army came to Iraq in the 1930s, leishmaniasis incapacitated up to 30 percent of the troops, said Lt. Col. Ray Dunton, a trained entomologist who's in Iraq serving as chief of preventive medicine for the 62nd Medical Brigade.

In 2004, hundreds of U.S. soldiers also were infected. Preventive medicine teams went into action, spraying insecticide and urging troops to use insect repellant. Infestations dropped from an average of 140 a month to nearly zero. Only 10 people have been diagnosed with leishmaniasis this year.

Still, the proportion of troops hospitalized for illness and non-combat injuries compared with combat injuries hasn't changed much since the wars in Korea and Vietnam. In part, that's because of a more aggressive philosophy about treatment, Ross said.

"Our evacuation statistics and our medical care statistics reflect that we have ratcheted up the standard of care," he said,

Evacuations also are spurred by the military's rule that anyone who won't recuperate within seven days of being hospitalized must be flown out of the country. That keeps beds open in case of a major casualty incident.

No illness or injury dominates the list of non-combat evacuations, Ross said. Injuries from vehicle accidents are a big cause of evacuations, as are hypertension-related illness, respiratory problems, kidney stones and back and joint problems.

In some cases, troops are clearly glad to get out. For many, though, the notion of leaving their unit and buddies over a problem unrelated to combat is frustrating.

"People work hard to get back. That's one of the big reasons we get so many people back," he said.